Interpersonal hypersensitivity and Social Cognition in Borderline Personality Disorder

TL;DR: In this paper, the authors investigated some key mechanisms underlying hypersensitivity to social threats in individuals with BPD traits from developmental, cognitive, and interpersonal perspectives using a multimethod approach and found that attachment anxiety and self-criticism mediated and moderated the association between rejection sensitivity and BPD features.

Abstract: Borderline personality disorder (BPD) is a serious psychiatric condition, which is characterised by interpersonal difficulties, intense fears of abandonment, affective instabilities, and impulsivity. The current research investigated some key mechanisms underlying hypersensitivity to social threats in individuals with BPD traits from developmental, cognitive, and interpersonal perspectives using a multimethod approach. Study 1, using self-report measurements, found that developmental factors including attachment anxiety and self-criticism mediated and moderated the association between rejection sensitivity and BPD features (n = 256). Study 2, using the similar methodological approach, found that intolerance of ambiguity and effortful control mediated and moderated the association between rejection sensitivity and BPD features (n = 256). Study 3 examined the impact of the activation of the attachment system on learning among people with BPD features (n = 96) using the Go/No-go paradigm. Study 4 investigated the impact of ambiguous social interactions on effortful control and mentalizing using a behavioural paradigm (n = 42). Study 5 examined the effect of expectation violation and social rejection, manipulated by the Cyberball paradigm, on effortful control and mentalizing in non-clinical participants (n = 123). Study 6 examined the effect of inclusive and exclusive social interactions, manipulated by the Cyberball paradigm, on mentalizing in BPD patients (n = 22) compared to healthy individuals (n = 28). Overall, results indicate that possible maladaptive coping strategies (anxious attachment, self-criticism) may be developed in response to heightened rejection sensitivity among individuals with BPD features. Furthermore, social cues perceived as threats (ambiguity, social interactions) may 4 activate the attachment system and impair various cognitive functions including contingency learning, effortful control and mentalizing among individuals with BPD symptoms. Future studies are needed to replicate the current findings and examine the impact of negative emotional arousal in response to interpersonal threats on cognitive capacities in larger non-clinical and clinical BPD populations.